Breaking News: Amb. Goosby to head new Global Health Diplomacy office, will continue to lead PEPFAR

Global AIDS Coordinator Ambassador Eric Goosby will head the new Office of Global Health Diplomacy at the State Department, while retaining, at least for the immediate future, control over the President’s Emergency Plan For AIDS Relief, the program he has headed for the last three years. The Global Health Diplomacy office was announced last July as the successor to President Obama’s Global Health Initiative. GHI, a response to neglected and preventable health threats in poor countries, was launched in 2009 and originally planned as a 6-year effort.

Goosby will be joined in creating the Global Health Diplomacy office by Leslie Rowe, previously U.S. Ambassador to Mozambique, who will be in charge of its day to day operations.

Goosby was one of four agency heads responsible for putting the Global Health Initiative’s goals into action. Funding for the program never materialized though, and while the initiative released preliminary progress reports describing its work, the decision announced in July to create an office in the State Department was called an elevation of its mission, while, evidently in a different form.

The new office, Goosby wrote in a blog piece today, will “play an important supportive role to Ambassadors and health teams on the ground, fortifying high-level diplomatic engagement to strengthen the capacity and political will to build strong, country-owned health systems.”

As Global AIDS Coordinator, Goosby has led PEPFAR in a transition from emergency to sustainable response, stressing the need to strengthen health systems in country while providing evidence-based HIV epidemic interventions. He launched the program’s first scientific advisory board two years ago, using the input of researchers and clinicians to guide PEPFAR responses.

A former member of the scientific advisory committee of the Center for Global Health Policy, which produces this blog, and a board member of the HIV Medicine Association, Goosby was involved in HIV prevention and treatment efforts from the time the epidemic was recognized here, in 1981. The principal investigator for several AIDS clinical trials, he developed strategies to treat and retain HIV-positive injecting drug users, a focus he continued to discuss the importance of in his PEPFAR role. During the Clinton administration he served as director of the Office of HIV/AIDS Policy in the Department of Health and Human Services and as the deputy director of the White House National AIDS Policy Office.

He then helped develop HIV/AIDS treatment programs internationally, including in Rwanda and the Ukraine, and said that his global HIV work heightened his awareness of the toll of tuberculosis on people living with HIV.

On the eve of his swearing in as Global AIDs Coordinator, in 2009, he told a Science Insider writer that not addressing the larger health needs of those accessing HIV care is short-sighted.

“We need to look at how to build country-based, country-run, country-owned delivery systems,” he said, in the Science Insider interview. “The President and Secretary Clinton have been very clear about wanting all the vertical programs – HIV, TB, malaria, immunization, maternal and child health – to now look at expanding the service constellation and bringing in those broader health needs of what is a complete overlap of populations.”

By then, the Global Health Initiative had been announced, several months earlier, as a planned $63 billion, 6-year broad-based global health effort. While it had not yet taken form, HIV-treatment advocates wondered what the impact of another big-figure program, with a diffused mission, and at a time of generally uncertain funding would be on the progress of PEPFAR. Numbers have supplied one answer since: the day Goosby was sworn in, 2.4 people were getting antiretroviral treatment through PEPFAR and today the number is 5.1 million, an accelerated pace of expanded treatment access that PEPFAR’s Blueprint for an AIDS-free generation, put together under his direction and released Nov. 29, indicates will be continued.

As it turned out, it was the Global Health Initiative, an ambitious effort to coordinate the work of PEPFAR, the US Agency for International Development, The Centers for Disease Control and Prevention, agencies that shared, perhaps more than anything else, competing needs, that seemed to falter. As Washington emptied for the July 4 holiday earlier this year, a short statement signed by the heads of the four agencies, Goosby, USAID Administrator Rajiv Shah, CDC Director Thomas Frieden and GHI director Lois Quam appeared on the GHI website, announcing the office would close. While the same announcement heralded a succeeding Office of Global Health Diplomacy that would carry on the GHI mission, the timing and placement of the announcement left global health advocates wondering what the future of the initiative’s mission would be.

The answer came today, in Goosby’s blog, in which he described how the office would (his bold lettering):

“Support our ambassadors on the ground, where our investments are translated into lives saved. As called for in the QDDR and as described in Secretary Clinton’s call promoting “smart power,” the role of ambassadors in the global health arena will be elevated as they pursue diplomatic strategies and partnerships within countries to foster better health outcomes. We will provide ambassadors with expertise, support and tools to help them effectively work with partner country officials on global health issues affecting their people.

“Strengthen sustainability of health programs by supporting partner countries as they work to meet the health care needs of their own people and eventually achieve country ownership. We will work with ambassadors to build political will in countries, in pursuit of sustainable health systems without barriers to care.

“Foster shared responsibility by supporting countries to coordinate donor nations, multilateral institutions, civil society, the private sector, faith-based organizations, foundations and community members. Stronger coordination and alignment will strengthen overall investments in global health, bring more donors to the table and better leverage U.S. investments. We will convene and work with U.S. government agencies representing our interests in multilateral organizations to advance our global health priorities and improve and save more lives. “

Rowe, who served as ambassador to Mozambique from 2009 to 2012, joined the Foreign Service in 1983. She previously served as the U.S. Ambassador to Papua New Guinea, Solomon Islands, and the Vanautu, and as Deputy Chief of Mission at the U.S. Embassy in Nairobi, Kenya, the largest U.S. Embassy in sub-Saharan Africa, according to her state department biography. She is scheduled to join the office in January, a State Department release said.